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Noninvasive detection of early pulmonary vascular dysfunction in scleroderma.
MedLine Citation:
PMID:  19497725     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: Pulmonary arterial hypertension is a serious complication in scleroderma and early diagnosis is warranted. PATIENTS AND METHODS: 33 Scleroderma patients (mean age 54 [SD 11] years) with normal systolic pulmonary artery pressure (sPAP), right and left ventricular parameters at rest were enrolled in this study. They were investigated by echocardiography during physical exercise and hypoxia. A hypertensive pulmonary vascular reaction was diagnosed when sPAP inappropriately increased during exercise compared to individual exercise tolerance, or if sPAP was >40mm Hg during hypoxia exposure, respectively. RESULTS: In 17 patients there was a normal increase of sPAP at exercise of 34 [8]mm Hg (mean VO2 max 70 [17]% predicted), and 29 [5]mm Hg during hypoxia. Sixteen patients developed a hypertensive pulmonary vascular response with a sPAP of 47 [9]mm Hg during exercise (VO2max 64 [15]% pred.), and 54 [7]mm Hgmm Hg during hypoxia, respectively. The sPAP/VO2 max ratio was higher in patients with a hypertensive response (0.76 [0.17] vs. 0.49 [0.12] p<0.0001). There was no difference in scleroderma subtype, duration of disease, gender or age between groups. During a 3-year follow up one patient with a hypertensive response developed manifest pulmonary arterial hypertension. CONCLUSION: Non-invasive assessment of pulmonary circulation during physical exercise and/or hypoxia enables screening for pulmonary vascular dysfunction in scleroderma.
Authors:
F Reichenberger; R Voswinckel; R Schulz; O Mensch; H A Ghofrani; H Olschewski; W Seeger
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-06-03
Journal Detail:
Title:  Respiratory medicine     Volume:  103     ISSN:  1532-3064     ISO Abbreviation:  Respir Med     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-05     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908438     Medline TA:  Respir Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  1713-8     Citation Subset:  IM    
Affiliation:
University Giessen Lung Centre, University Hospital Giessen, Germany. frank.reichenberger@innere.med.uni-giessen.de
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